NPI | 1043652803 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8689112-4405) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: UT 8689112-4405) |
Enumeration Date | 2013-07-22 |
Last Update Date | 2019-06-24 |